Medical Students Battle for Pro-Choice Education

Editors Note: Yesterday the U.S. Supreme Court heard oral arguments in Stenberg v. Carhart challenging a Nebraska law limiting types of abortion procedures. Pro-choice advocates argue the case is about political leaders banning the safest, most common second trimester abortion procedures with no regard for the health and liberty of women. The court’s decision is expected in June.

More than 150 medical students met in Pittsburgh in mid-April to devise strategies for incorporating abortion education into medical school curricula, to learn how to perform abortions safely and to hear war stories from the current generation of abortion providers.

Sponsored by Medical Students for Choice, the group’s three-day annual meeting demonstrated a high level of grassroots interest among medical students for learning about this controversial procedure, says Alia Matthews, a third-year medical student at Pittsburgh University Medical School and president of the student group.

The organization was formed in 1993 because medical students were frustrated that they weren’t being taught how to perform abortions. It now has 7,000 members and chapters at about 100 medical schools in the United States, Canada and Puerto Rico, she says.

Each of the group’s chapters sets its own agenda for furthering the national group’s goals, Matthews says. Some chapters start dialogues with their deans, sponsor lectures or become politically active. As a result some medical schools have added electives on abortion training to the curricula, Matthews says.

In 1995, the organization succeeded in persuading the Accreditation Council for Graduate Medical Education to require all obstetrical/gynecological programs to include abortion as a routine component of their training.

But anti-abortion lawmakers are trying to reverse this decision by stripping the medical education council of its power to regulate professional medical standards for training, says the student group.

Currently, only 12 percent of U.S. residency programs in obstetrics and gynecology require routine training in first-trimester abortions, Matthews says.

Adding to the problem is the fact that only 7 percent of all abortions are performed in hospitals, where most medical students and residents receive most of their training.

Several students who attended the Pittsburgh conference said they went to meet with other medical students working to enhance their medical education.

Divya Gupta, a second-year medical student at Albert Einstein College of Medicine in the Bronx, says she has received no formal instruction so far in how to do abortions or how to counsel women about the procedure.

“I have to ask to work with someone who’s performing abortions. It’s not something that’s offered to me automatically,” she says.

Tony Charuvastra, a fourth-year medical student at Brown University in Providence, R.I., says attending the conference was a good opportunity to hear from the older generation of abortion providers and be reminded of the consequences of not being able to provide a safe abortion.

“It’s about 10 times safer for a woman than natural childbirth. The mortality rate is extremely low. That’s an important thing for medical students to realize,” the aspiring psychiatrist says.

At Brown University, Charuvastra says, medical students may sit in on counseling sessions at a Planned Parenthood clinic, do preoperative histories and physical exams there as well as watch the procedure being performed.

“It’s better there than in most places,” he said, adding that learning to do abortions is important even for physicians who do not plan to perform them.

More than 40 percent of all women will have had an abortion by the end of their reproductive years, he notes. Consequently, he believes all physicians should know how to counsel and treat women who are seeking or have had an abortion.

“You never know who’s going to have complications, so you need the training to deal with those complications.”

Matthews of Medical Students for Choice says that excluding abortion from medical school curricula leaves medical students ill prepared to counsel women about their reproductive health options and leaves medical students even less prepared to decide whether they want to offer abortion services once they become physicians.

“We want abortion training to be routine so everyone has the opportunity to learn it,” she says. Given that abortion is the most common surgical procedure done for women, it’s clear that whatever specialty physicians go into, physicians will encounter someone who needs counseling about abortion, she adds.

Medical Students for Choice also recently published a resource guide to abortion training in residency programs based on a survey of medical schools done in conjunction with the National Abortion Federation.

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